Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 054277 | NY |
NPI | 1023198793 |
---|---|
Provider Name | Dr. Robert Mark Dolman |
First Address | New York, NY 10017-6221 |
Second Address | New York, NY 10017-6221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 25/03/2016 |